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      Quality of life of the Indonesian general population: Test-retest reliability and population norms of the EQ-5D-5L and WHOQOL-BREF

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          Abstract

          Objectives

          The objective of this study is to obtain population norms and to assess test-retest reliability of EQ-5D-5L and WHOQOL-BREF for the Indonesian population.

          Methods

          A representative sample of 1056 people aged 17–75 years was recruited from the Indonesian general population. We used a multistage stratified quota sampling method with respect to residence, gender, age, education level, religion and ethnicity. Respondents completed EQ-5D-5L and WHOQOL-BREF with help from an interviewer. Norms data for both instruments were reported. For the test-retest evaluations, a sub-sample of 206 respondents completed both instruments twice.

          Results

          The total sample and test-retest sub-sample were representative of the Indonesian general population. The EQ-5D-5L shows almost perfect agreement between the two tests (Gwet’s AC: 0.85–0.99 and percentage agreement: 90–99%) regarding the five dimensions. However, the agreement of EQ-VAS and index scores can be considered as poor (ICC: 0.45 and 0.37 respectively). For the WHOQOL-BREF, ICCs of the four domains were between 0.70 and 0.79, which indicates moderate to good agreement. For EQ-5D-5L, it was shown that female and older respondents had lower EQ-index scores, whilst rural, younger and higher-educated respondents had higher EQ-VAS scores. For WHOQOL-BREF: male, younger, higher-educated, high-income respondents had the highest scores in most of the domains, overall quality of life, and health satisfaction.

          Conclusions

          This study provides representative estimates of self-reported health status and quality of life for the general Indonesian population as assessed by the EQ-5D-5L and WHOQOL-BREF instruments. The descriptive system of the EQ-5D-5L and the WHOQOL-BREF have high test-retest reliability while the EQ-VAS and the index score of EQ-5D-5L show poor agreement between the two tests. Our results can be useful to researchers and clinicians who can compare their findings with respect to these concepts with those of the Indonesian general population.

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          EuroQol: the current state of play.

          R. Brooks (1996)
          The EuroQol Group first met in 1987 to test the feasibility of jointly developing a standardised non-disease-specific instrument for describing and valuing health-related quality of life. From the outset the Group has been multi-country, multi-centre, and multi-disciplinary. The EuroQol instrument is intended to complement other forms of quality of life measures, and it has been purposefully developed to generate a cardinal index of health, thus giving it considerable potential for use in economic evaluation. Considerable effort has been invested by the Group in the development and valuation aspects of health status measurement. Earlier work was reported upon in 1990; this paper is a second 'corporate' effort detailing subsequent developments. The concepts underlying the EuroQol framework are explored with particular reference to the generic nature of the instrument. The valuation task is reviewed and some evidence on the methodological requirements for measurement is presented. A number of special issues of considerable interest and concern to the Group are discussed: the modelling of data, the duration of health states and the problems surrounding the state 'dead'. An outline of some of the applications of the EuroQol instrument is presented and a brief commentary on the Group's ongoing programme of work concludes the paper.
          Article 0 comments Cited 826 times – based on 0 reviews     Review now
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            Health-related quality of life measured using the EQ-5D–5L: South Australian population norms

            Nikki McCaffrey, Billingsley Kaambwa, David Currow … (2016)
            Background Although a five level version of the widely-used EuroQol 5 dimensions (EQ-5D) instrument has been developed, population norms are not yet available for Australia to inform the future valuation of health in economic evaluations. The aim of this study was to estimate HrQOL normative values for the EQ-5D-5L preference-based measure in a large, randomly selected, community sample in South Australia. Methods The EQ-5D-5L instrument was included in the 2013 South Australian Health Omnibus Survey, an interviewer-administered, face-to-face, cross-sectional survey. Respondents rated their level of impairment across dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and global health rating on a visual analogue scale (EQ-VAS). Utility scores were derived using the newly-developed UK general population-based algorithm and relationships between utility and EQ-VAS scores and socio-demographic factors were also explored using multivariate regression analyses. Results Ultimately, 2,908 adults participated in the survey (63.4 % participation rate). The mean utility and EQ-VAS scores were 0.91 (95 CI 0.90, 0.91) and 78.55 (95 % CI 77.95, 79.15), respectively. Almost half of respondents reported no problems across all dimensions (42.8 %), whereas only 7.2 % rated their health >90 on the EQ-VAS (100 = the best health you can imagine). Younger age, male gender, longer duration of education, higher annual household income, employment and marriage/de facto relationships were all independent, statistically significant predictors of better health status (p < 0.01) measured with the EQ-VAS. Only age and employment status were associated with higher utility scores, indicating fundamental differences between these measures of health status. Conclusions This is the first Australian study to apply the EQ-5D-5L in a large, community sample. Overall, findings are consistent with EQ-5D-5L utility and VAS scores reported for other countries and indicate that the majority of South Australian adults report themselves in full health. When valuing health in Australian economic evaluations, the utility population norms can be used to estimate HrQOL. More generally, the EQ-VAS score may be a better measure of population health given the smaller ceiling effect and broader coverage of HrQOL dimensions. Further research is recommended to update EQ-5D-5L population norms using the Australian general population specific scoring algorithm once this becomes publically available.
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              From translation to version management: a history and review of methods for the cultural adaptation of the EuroQol five-dimensional questionnaire.

              Rosalind Rabin, Claire Gudex, Caroline Selai … (2015)
              The EuroQol five-dimensional (EQ-5D) questionnaire is used worldwide as a patient-reported outcome (PRO) instrument for the measurement and valuation of health. Several variants of the instrument now exist, including versions with three and five levels of severity and one for respondents aged 8 to 14 years. From the outset, a demand for new language versions of the EQ-5D questionnaire meant that there was a need to implement standardized procedures, which ensured that such versions were produced following international recommendations for the cultural adaptation of patient-reported outcomes. The availability of new variants and formats of the instrument, such as telephone-administered or electronic formats, complicated the task of providing and controlling the quality of cultural adaptations. Although cultural adaptations of the instrument are widely used, the procedures currently used to produce them have not been widely disseminated. The present article therefore describes the evolution of the production of other language versions of the instrument from the earliest days of simultaneous production and translation of the EQ-5D questionnaire to the more recent, broader-based strategy of version management. We describe current adaptation procedures and innovations within those procedures. We also describe how version management is organized within the EuroQol Group, review aspects related to quality control, and provide an overview of the number of currently available language versions for each variant of the EQ-5D questionnaire: three-level, five-level, and youth versions. We conclude by discussing some of the relevant issues related to cultural adaptation for frequently used instruments such as the EQ-5D questionnaire. © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Published by International Society for Pharmacoeconomics and Outcomes Research (ISPOR) All rights reserved.
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                Author and article information

                Contributors
                Fredrick Dermawan Purba:
                ORCID: http://orcid.org/0000-0002-7336-3043
                Role: Formal analysisRole: InvestigationRole: Project administrationRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Joke A. M. Hunfeld: Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Aulia Iskandarsyah: Role: Project administrationRole: ResourcesRole: Writing – review & editing
                Titi Sahidah Fitriana: Role: InvestigationRole: Project administrationRole: ResourcesRole: Writing – review & editing
                Sawitri S. Sadarjoen: Role: ResourcesRole: Writing – review & editing
                Jan Passchier: Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Jan J. V. Busschbach: Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Nan Luo: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 11 May 2018
                Publication date Collection: 2018
                Volume: 13
                Issue: 5
                Electronic Location Identifier: e0197098
                Affiliations
                [1 ] Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
                [2 ] Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
                [3 ] Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
                [4 ] Faculty of Psychology, YARSI University, Jakarta, Indonesia
                [5 ] Department of Clinical, Neuro & Developmental Psychology, VU University, Amsterdam, The Netherlands
                National University of Singapore, SINGAPORE
                Author notes

                Competing Interests: The following author is member of the EuroQol Research Foundation (the copyright holders of EQ-5D-5L): Jan J.V. Busschbach. There are no other conflicts of interest.

                Author information
                http://orcid.org/0000-0002-7336-3043
                Article
                Publisher ID: PONE-D-17-41120
                DOI: 10.1371/journal.pone.0197098
                PMC ID: 5947896
                PubMed ID: 29750806
                SO-VID: cab9115f-92f9-426a-a9e6-9d0be07a5547
                Copyright © © 2018 Purba et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 21 November 2017
                Date accepted : 26 April 2018
                Page count
                Figures: 3, Tables: 9, Pages: 20
                Funding
                Funded by: Directorate General of Higher Education of Indonesia
                Award ID: 58.18/E4.4/2014
                Award Recipient :
                ORCID: http://orcid.org/0000-0002-7336-3043
                Funded by: funder-id http://dx.doi.org/10.13039/501100006419, EuroQol Research Foundation;
                Award ID: 2013240
                Award Recipient :
                The research was financed by the EuroQol Group (EQ Project number: 2013240) and Directorate General of Higher Education of Indonesia ( www.ristekdikti.go.id; number: 58.18/E4.4/2014). There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Quality of Life
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Socioeconomic Aspects of Health
                Subject: Medicine and Health Sciences
                Subject: Public and Occupational Health
                Subject: Socioeconomic Aspects of Health
                Subject: Social Sciences
                Subject: Anthropology
                Subject: Cultural Anthropology
                Subject: Religion
                Subject: Social Sciences
                Subject: Sociology
                Subject: Religion
                Subject: People and Places
                Subject: Population Groupings
                Subject: Ethnicities
                Subject: Social Sciences
                Subject: Sociology
                Subject: Education
                Subject: Educational Attainment
                Subject: Research and Analysis Methods
                Subject: Database and Informatics Methods
                Subject: Health Informatics
                Subject: Medicine and Health Sciences
                Subject: Epidemiology
                Subject: Ethnic Epidemiology
                Subject: People and Places
                Subject: Geographical Locations
                Subject: Asia
                Subject: Indonesia
                Subject: People and Places
                Subject: Geographical Locations
                Subject: Oceania
                Subject: Indonesia
                Custom metadata
                Data Availability All relevant data are within the paper and its Supporting Information files.

                ScienceOpen disciplines: Uncategorized
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